How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $22.39 Median $77.62 Typical High $79.43 | Facility | None | $22.39 | $77.62 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $79.43 Typical High $85.11 | Professional | None | $37.15 | $79.43 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,019.95 Typical High $3,801.89 | Facility | None | $575.44 | $3,019.95 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $41.69 | Professional | None | $19.95 | $23.44 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $117.49 | Facility | None | $63.10 | $75.86 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $123.03 | Professional | None | $66.07 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $47.86 Typical High $426.58 | Professional | None | $21.38 | $47.86 | $426.58 |
United Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $75.86 | Professional | None | $25.12 | $33.11 | $75.86 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $58.88 Typical High $60.26 | Professional | 54 · Surgery only | $57.54 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.13 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 49th of 51
$35.48
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.